Hospital for Rheumatic Diseases, Haugesund, Norway.
Department of Clinical Science, University of Bergen, Bergen, Norway.
Arthritis Res Ther. 2019 Jun 25;21(1):154. doi: 10.1186/s13075-019-1945-4.
Our objective was to determine the survival and causes of death in a large and well-characterized cohort of patients with giant cell arteritis (GCA).
This is a hospital-based, retrospective, observational cohort study including patients diagnosed with GCA in Western Norway during 1972-2012. Patients were identified through computerized hospital records using the International Classification of Diseases (ICD)-coding system. Medical records were reviewed. Patients were randomly assigned population controls matched on age, sex, and geography from the Central Population Registry of Norway (CPRN). Date and cause of death were obtained from the Norwegian Cause of Death Registry (NCoDR). The survival was analyzed using Kaplan-Meier methods with the Gehan-Breslow test and the causes of death using cumulative incidence and Cox models for competing risks.
We identified 881 cases with a clinical diagnosis of GCA of which 792 fulfilled the American College of Rheumatology (ACR) 1990 classification criteria. Among those fulfilling the ACR criteria, 528 were also biopsy-verified. Cases were matched with 2577 population controls. A total of 490 (56%) GCA patients and 1517 (59%) controls died during the study period. We found no difference in the overall survival of GCA patients compared to controls, p = 0.413. The most frequent underlying causes of death in both groups were diseases of the circulatory system followed by cancer. GCA patients had increased risk of dying of circulatory disease (HR 1.31, 95% CI 1.13-1.51, p < 0.001) but lower risk of dying of cancer (HR 0.56, 95% CI 0.42-0.73, p < 0.001) compared to population controls.
We found no difference in the overall survival of GCA patients compared to matched controls, but there were differences in the distribution of underlying death causes.
本研究旨在明确巨细胞动脉炎（GCA）患者的生存情况及其死因。
本研究为基于医院的回顾性观察性队列研究，纳入了 1972 年至 2012 年期间在挪威西部确诊为 GCA 的患者。通过使用国际疾病分类（ICD）编码系统对计算机化的医院记录进行检索，以确定患者。对病历进行了回顾。按照年龄、性别和地理区域，通过挪威中央人口登记处（CPRN）对患者进行了随机匹配，以获得对照人群。从挪威死因登记处（NCoDR）获取患者的死亡日期和死因。使用 Kaplan-Meier 方法结合 Gehan-Breslow 检验进行生存分析，使用累积发病率和 Cox 模型进行竞争风险分析。
本研究共纳入 881 例临床诊断为 GCA 的患者，其中 792 例符合美国风湿病学会（ACR）1990 年分类标准。在符合 ACR 标准的患者中，528 例患者接受了活检验证。对这些患者进行了随机匹配，共匹配到 2577 例对照人群。研究期间，GCA 患者中有 490 例（56%）死亡，对照人群中有 1517 例（59%）死亡。与对照人群相比，GCA 患者的总生存无差异（p=0.413）。两组患者的主要死亡原因均为循环系统疾病，其次为癌症。与对照人群相比，GCA 患者死于循环系统疾病的风险更高（HR 1.31，95% CI 1.13-1.51，p<0.001），死于癌症的风险更低（HR 0.56，95% CI 0.42-0.73，p<0.001）。
与匹配的对照人群相比，GCA 患者的总体生存无差异，但死因分布存在差异。
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